Bortolotti U, Milano A, Mossuto E, Mazzaro E, Thiene G, Casarotto D
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S216-20. doi: 10.1016/0003-4975(95)00255-j.
Two series of patients who received a Hancock standard (HS) (1970 to 1983) and a Hancock II (HII) (1983 to 1992) porcine bioprosthesis were reviewed to compare bioprosthetic durability. Patients with HS porcine bioprostheses (n = 769) differed from those with HII bioprostheses mostly in mean age at operation (47 +/- 12 versus 62 +/- 9 years; p < 0.001); the latter prosthesis was implanted mostly in patients older than 50 years. At 8 years after operation, actuarial survival was 57% +/- 4% after aortic, 61% +/- 3% after mitral, and 39% +/- 7% after mitral-aortic valve replacement with the HS bioprosthesis; actuarial survival was 51% +/- 9% after aortic, 66% +/- 6% after mitral, and 49% +/- 10% after mitral and aortic valve replacement with an HII bioprosthesis. No cases of structural deterioration of HII bioprostheses were observed at 8 years in any patients. Actuarial freedom from structural valve deterioration was 78% +/- 4% after aortic, 88% +/- 3% after mitral, and 79% +/- 7% after mitral-aortic valve replacement with an HS bioprosthesis at 8 years. In all patients greater than 50 years of age, actuarial freedom from structural valve deterioration at 8 years was 90% +/- 3% in patients with an HS bioprosthesis and 100% in those with an HII bioprosthesis (p = 0.08). A trend to an improved durability of the HII bioprosthesis compared with the HS was observed during the first 8 postoperative years. Because these results could be influenced partly by the age difference in the two series of patients, a longer follow-up is needed to confirm these data.
回顾了两组分别接受汉考克标准型（HS）（1970年至1983年）和汉考克二代（HII）（1983年至1992年）猪生物瓣膜的患者，以比较生物瓣膜的耐久性。接受HS猪生物瓣膜的患者（n = 769）与接受HII生物瓣膜的患者主要在手术时的平均年龄上存在差异（47±12岁对62±9岁；p < 0.001）；后一种瓣膜主要植入50岁以上的患者。术后8年，HS生物瓣膜置换主动脉瓣后精算生存率为57%±4%，二尖瓣置换后为61%±3%，二尖瓣-主动脉瓣置换后为39%±7%；HII生物瓣膜置换主动脉瓣后精算生存率为51%±9%，二尖瓣置换后为66%±6%，二尖瓣和主动脉瓣置换后为49%±10%。在8年时，未观察到任何患者的HII生物瓣膜出现结构恶化情况。HS生物瓣膜置换主动脉瓣后8年无结构瓣膜恶化的精算自由度为78%±4%，二尖瓣置换后为88%±3%，二尖瓣-主动脉瓣置换后为79%±7%。在所有50岁以上的患者中，HS生物瓣膜患者8年时无结构瓣膜恶化的精算自由度为90%±3%，HII生物瓣膜患者为100%（p = 0.08）。在术后的前8年观察到HII生物瓣膜与HS相比耐久性有改善的趋势。由于这些结果可能部分受到两组患者年龄差异的影响，需要更长时间的随访来证实这些数据。
